Healthcare Provider Details

I. General information

NPI: 1972985489
Provider Name (Legal Business Name): CHRISTINE TRUSCHKA LARSEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2015
Last Update Date: 06/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1835 SW 34TH CT
OCALA FL
34474-2836
US

IV. Provider business mailing address

1835 SW 34TH CT
OCALA FL
34474-2836
US

V. Phone/Fax

Practice location:
  • Phone: 352-572-8814
  • Fax:
Mailing address:
  • Phone: 352-572-8814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateFL

VIII. Authorized Official

Name: CHRISTINE TRUSCHKA LARSEN
Title or Position: NURSE PRACTITIONER
Credential: ARNP
Phone: 352-572-8814